This invention relates to electrodes for laryngeal electromyography and in particular to an electrode that is attachable to an insert device of sorts and that is size adjustable to fit the particular application, and in particular for use in pediatrics.
During thyroid surgery there is a substantial hazard that the recurrent laryngeal nerve may be severed, stretched or bruised during surgery on, about or near the thyroid gland. The hazard is a result of several factors, including the fact that the recurrent laryngeal nerve lies just posterior to the most inferior portion of the thyroid gland, and is very small and delicate. It can be quite difficult to distinguish this nerve from the background tissue when the area about the thyroid gland is inflamed, as well as covered with blood following the initial incision. As the result, the risk of vocal cord damage or paralysis following thyroid surgery is very high, and also is quite serious in that it can result in the patient's complete loss of speech. Even if the laryngeal nerve has simply been stretched or bruised, the loss of speech may last for several months. In the unfortunate cases where the nerve is completely severed, the paralysis is permanent, and surgical attempts to repair the same have not yet proven successful.
The use of laryngeal electromyography with surface electrodes to locate the recurrent laryngeal nerve has proven successful, as discussed in U.S. Pat. No. 5,178,145 issued to Rea. But the types and sizes of electrodes available are limited. Most electrodes are self retaining in that they have some sort of “built in” means for insertion, such as a paddle or handle. Most electrodes are also fixed in size and may not be adaptable for use on all patients and in particular pediatric patients, small children, and in some cases small adults.